Determinants of radiographic progression in early psoriatic arthritis: insights from a real-world cohort.

Autor:	Koc GH; Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands g.yanmaz-koc@erasmusmc.nl., Kok MR; Department of Rheumatology and Clinical Immunology, Maasstad Hospital, Rotterdam, The Netherlands., do Rosario Y; Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands., Luime JJ; Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands., Tchetverikov I; Department of Rheumatology, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands., Kasiem FR; Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands., Korswagen LA; Department of Rheumatology, Franciscus Gasthuis & Vlietland, Rotterdam, The Netherlands., Bijsterbosch J; Department of Rheumatology, Amphia Hospital, Breda, The Netherlands., Goekoop-Ruiterman YPM; Department of Rheumatology, Haga Hospital, Den Haag, The Netherlands., van Oosterhout M; Department of Rheumatology, Groene Hart Hospital, Gouda, The Netherlands., Baudoin P; Department of Rheumatology, Reumazorg Zuid West Nederland, Roosendaal, The Netherlands., Kok P; Department of Rheumatology, Reinier de Graaf Gasthuis, Delft, The Netherlands., Dolhain RJEM; Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands., Vis M; Department of Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2024 May 24; Vol. 10 (2). Date of Electronic Publication: 2024 May 24.
DOI:	10.1136/rmdopen-2024-004080
Abstrakt:	Objective: Persistent articular inflammation in psoriatic arthritis (PsA) is associated with radiographic damage. Despite advances in diagnosis and therapy, radiographic structural damage remains prevalent in PsA. To elucidate this topic, we studied which baseline clinical characteristics determine radiographic progression. Methods: For this analysis, data were used from DEPAR (Dutch South West Psoriatic Arthritis) Study, a real-world cohort of patients with newly diagnosed PsA. Radiographic changes were assessed using the modified Total Sharp/van der Heijde Score (mTSS) for PsA. Univariable-multivariable mixed-effects negative binomial regression analysis was applied to define baseline predictors for radiographic progression over time. Results: The study included 476 patients with early PsA with 1660 hand and feet radiographs from four different time points (baseline, first, second and third year). The progressive group (n=71) had a higher mTSS compared with the non-progressive group (n=405) at diagnosis (17 (3-36) vs 0 (0-1)). A comparison of the two groups revealed that the progressive group had significantly older (59 (12) vs 49 (13)) and a higher rate of the presence of swollen joints (93% vs 78%) at diagnosis. Multivariable analysis identified age (incidence rate ratio (IRR)=1.10, p=0.000), sex (female) (IRR=0.48, p=0.043) and baseline mTSS (IRR=1.11, p=0.000) as significant determinants of radiographic change over time. For the progressive subset, additionally, the multivariable analysis highlighted baseline Disease Activity in PSoriatic Arthritis (IRR=1.05, p=0.006) and swollen joint count (IRR=1.07, p=0.034) as predictors. Conclusions: According to this real-world cohort, patients with early PsA exhibit minimal radiographic progression under current treatment protocols. This study indicates that while old age and initial radiographic damage predict progression, female sex confers a protective effect on it. Furthermore, disease activity score and swollen joints emerged as predictors for radiographic changes during the follow-up in progressive patients. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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